Global Collaborations for Cervical Cancer: Can the East-West Alliance Facilitate Treatment for all?

Despite the advances in the primary prevention of cervical cancer, there is an absolute increase in the incidence of cervical cancer as a result of an increase in world population. A vast majority of patients in low and low-middle income countries continue to present at a locally advanced stage, necessitating treatment with chemoradiation and brachytherapy. There is a dearth of equipment and trained professionals for the treatment of cervical cancer, especially in low and low-middle income countries. There is an urgent need to improve treatment availability and develop better treatments. Worldwide trends, however, reveal a low number of therapeutic and innovative research trials in cervical cancer. The present article elucidates the existing challenges and provides solutions to improve outcomes. The proposed strategies hinge on strengthening collaborations for global advocacy.

Prospective evaluation of the diagnostic potential of LipL32 based latex agglutination test for Bovine leptospirosis

The Livestock Sector of India plays an important role in livelihood security and socioeconomic development of rural households. Leptospirosis is an important zoonotic disease responsible for septicaemia, interstitial nephritis, jaundice, abortion, reproductive problem in most of the animal species. Reproductive disturbances in bovine population is most often restricted to investigation of brucellosis, however apart from brucellosis, there are many undiagnosed diseases like leptospirosis that takes a toll in the reproductive anomalies of cattle and buffalo. Hence, the present study was elucidated to screen the seroprevalence of Leptospira in cattle and buffalo in various hamlets of North India using a user friendly screening test i.e. LipL32 latex agglutination test. The overall seropositivity was found to be 26.01% (230/884) in case of bovine in this study and the LipL32 LAT showed a profound sensitivity and specificity with level of 94.97% and 99.53% respectively.

Management of multidrug-resistant tuberculosis in the 21st century

The spread of drug-resistant tuberculosis (TB) continues to be a global health crisis with increasing cases of multidrug-resistant TB (MDR-TB) being diagnosed worldwide. The identification and clinical management of MDR-TB is associated with additional problems related to resistance, diagnosis and treatment as compared to drug-susceptible TB. Treatment of MDR-TB usually involves therapy with long regimens of second-line drugs up to 24 months resulting in higher risks of serious adverse effects, lack of compliance and heightened economic burden on the patients. Issues such as increasing transmission of drug-resistant strains, poor diagnostic coverage and lengthy, toxic treatments need to be overcome by innovative approaches such as quick diagnostic tools and shorter drug regimens as already recommended by the World Health Organization (WHO) in its 2018 Global Tuberculosis Report. This review highlights the challenges being faced by clinicians worldwide in the diagnosis and treatment of MDR-TB.

An update on benznidazole for the treatment of patients with Chagas disease

Chagas disease is a vector-borne, systemic and chronic parasitic infection caused by Trypanosoma cruzi with approximately 8 million cases worldwide. The treatment for acute phase of Chagas disease consists of benznidazole and nifurtimox, although this treatment combination falls short in terms of efficacy against chronic phases of infection. This review provides an update on benznidazole progress and approval by the U.S. Food and Drug Administration in 2017 for the treatment of Chagas disease along with its lacunae.

Delafloxacin meglumine for the treatment of acute bacterial skin and skin structure infections (ABSSSI)

Delafloxacin meglumine (Baxdela, WQ-3034, ABT-492, RX-3341; Melinta Therapeutics) was approved by the U.S. Food and Drug Administration (FDA) in June 2017 for the treatment of acute bacterial skin and skin structure infections on the basis of data from two phase III trials. Delafloxacin is a broad-spectrum anionic fluoroquinolone and its distinct chemical structure increases its potency in acidic environments. It is known to inhibit DNA replication and repair by targeting DNA gyrase and topoisomerase IV. Delafloxacin is administered via both oral and parenteral routes. It has potent activity against methicillin-resistant Staphylococcus aureus and Streptococci, and is also effective against Enterobacteriaceae and Pseudomonas aeruginosa. Delafloxacin is currently in phase III evaluation for treatment of community-acquired pneumonia and was classified as a qualified infectious disease product by the U.S. FDA in its approval.

Cutaneous complications associated with breast augmentation: A review

Breast augmentation is one of the most popular and safe cosmetic procedures performed by plastic surgeons worldwide. Although breast implants are available in a number of different materials, silicone-filled implants remain the most common type. However, prior to the development of breast implants, various materials were injected into the soft tissues of the breasts to increase breast volume, which caused cutaneous complications and disfigurement. This review details the history of breast augmentation, the current methods used in augmentation surgery, and associated cutaneous complications.

Outcome of the modified Lapidus procedure for hallux valgus deformity during the first year following surgery: A prospective clinical and gait analysis study

BACKGROUND

The modified Lapidus procedure is a surgical option to treat moderate to severe hallux valgus deformity with good radio-clinical outcome. However, comprehensive biomechanical outcome evaluation of this surgery at mid-term follow-up is missing. This study assesses and compares the radio-clinical and gait outcome at 6 and 12 months following modified Lapidus procedure.

METHOD

Ten consecutive female patients with moderate to severe hallux valgus who underwent modified Lapidus procedure participated in the study. Comprehensive gait assessment was performed preoperatively, at 6 and 12 months postoperatively. Gait parameters including spatiotemporal, kinematics and plantar pressure were analyzed using pressure insoles and 3-dimensional inertial sensors. Outcome was evaluated using two clinical questionnaires, i.e. the American Orthopaedic Foot and Ankle Score and the Foot and Ankle Ability Measure, and X-rays.

FINDINGS

Three spatiotemporal, two kinematics, and seven plantar pressure parameters significantly improved between 6 months and 12 months postoperatively. Significant improvement in radiological and clinical outcome was reported at 6 and 12 months. The Foot and Ankle Ability Measure showed non-significant improvement at 12 months.

INTERPRETATION

The outcome of this study is consistent with the previously reported good clinical and radiological results at one year following Lapidus for moderate to severe hallux valgus. Twelve gait parameters demonstrated that outcome improves from 6 months to 12 months postoperative with room for further improvement at long term. The gait outcome in this study confirms the longer rehabilitation period following modified Lapidus procedure. Studies with a larger sample size are required to confirm these findings.

Genotypic and Pathogenic Diversity of Colletotrichum sublineola Isolates from Sorghum (Sorghum bicolor) and Johnsongrass (S. halepense) in the Southeastern United States

Anthracnose caused by Colletotrichum sublineola is an important disease of cultivated sorghum (Sorghum bicolor) worldwide. Anthracnose is also common on the ubiquitous wild sorghum relative Johnsongrass (S. halepense). Analysis of repetitive molecular fingerprinting markers revealed that isolates of C. sublineola from both hosts in the southeastern United States were genotypically diverse, with relatively few haplotypes found in more than one location. With few exceptions, isolates recovered from S. bicolor belonged to a population that was genetically distinct from the population recovered from S. halepense. Twenty-three isolates from cultivated sorghum were all pathogenic to at least one of 13 heritage inbred lines of S. bicolor. In all, 4 of 10 isolates from S. halepense were also pathogenic to one or more of the lines, while the rest caused no disease in greenhouse assays. The four pathogenic isolates from S. halepense were less aggressive, on average, than isolates from S. bicolor, although the ranges overlapped. Pathogenicity tests involving 15 representative pathogenic isolates from S. bicolor and S. halepense on eight heritage inbred lines of S. bicolor identified 12 races. The combined results of this study demonstrated that C. sublineola comprises two separate host-associated subpopulations in the field, even though some isolates from S. halepense were able to cause disease on S. bicolor under ideal greenhouse conditions. Nonetheless, the apparent existence of infrequent cross-infection events in the field, indicated by molecular fingerprinting, suggests that Johnsongrass has the potential to serve as a refuge and an incubator for genetic diversity in C. sublineola, which can complicate efforts to develop and deploy resistant sweet sorghum varieties in the region.

Delamanid for the treatment of pulmonary multidrug-resistant tuberculosis

Out of a handful of new drugs currently in clinical trials for the treatment of tuberculosis, delamanid, a nitro-dihydro-imidazole derivative, has successfully emerged. Delamanid is a novel mycolic acid biosynthesis inhibitor that is equally potent against drug-sensitive as well as drug-resistant Mycobacterium tuberculosis. One of the strongest points for delamanid is its inability to be metabolized by cytochrome P450 enzymes, making it a promising candidate to be used in combination therapies for the treatment of tuberculosis and HIV. Additionally, it has successfully completed phase II efficacy trials and has received conditional marketing authorization from the European Medicines Agency.